Some studies have revealed that COPD (chronic obstructive pulmonary disease) may affect as many as 1 out of 10 Americans. The exact incidence is unknown since this is a condition that often goes undiagnosed and is undertreated. Nevertheless it is a serious and debilitating disease which primarily affects smokers. In fact as many as 1 out of 5 people aged 30 or older who have been smoking for 10 years or more may have COPD. However, a significant proportion of younger COPD sufferers do not realize that they have this condition.
How To Spot COPD?
Chronic obstructive pulmonary disease (COPD) is a result of long term damage to the airways and lungs inflicted by tobacco smoking. There are two types of COPD – chronic bronchitis and emphysema. In chronic bronchitis the lower airways known as the bronchi (singular ~ bronchus) is persistently inflamed. With emphysema, the walls between the air sacs in the lungs become damaged with a thinning and loss of elasticity of the lung wall.
Eventually these conditions can lead to repeated lung infections (pneumonia), lung collapse and heart problems which may be fatal. COPD can be difficult to spot in the early stages. Most people may appear asymptomatic (without any symptoms) in the very early stages. However, as the condition progresses the symptoms become more apparent. Depending on the severity of COPD, the tissue damage may be irreversible.
Read more on what is COPD?
Who gets COPD?
COPD should be suspected in long term tobacco smokers. There is no definitive duration of tobacco smoking that will lead to COPD. For some smokers, COPD may start earlier than for others. Estimates of between 10 to 15 years of tobacco smoking have been claimed to lead to COPD but this can vary. It also depends on the quantity of tobacco smoked, age of a person, individual resistance, occupational exposure to irritants and air pollution.
Any person with repeated respiratory infections, difficulty breathing, persistent cough, chest discomfort and ongoing fatigue should be suspected of having COPD if they are a long term smoker. However, it is also important to note that COPD can occur in people who do not smoke tobacco. Secondhand smoke exposure can still increase the risk of a person in developing COPD as does occupational exposure to airborne irritants, even if the person never smoked.
Shortness of Breath
Shortness of breath is one of the most comoon symptoms of chronic obstructive pulmonary disease. It occurs in both emphysema and chronic bronchitis. The shortness of breath usually develops gradually and progressively worsens. It may be the only sign of emphysema whereas with bronchitis there are other respiratory symptoms like a cough. With chronic bronchitis the shortness of breath tends to worsen during episodes of acute flareups which are mainly due to bacterial infections of the bronchi and sometimes even the lungs (pneumonia).
A persistent cough is characteristic of chronic bronchitis. It can also occur in emphysema particularly during physical exertion. The cough in chronic bronchitis is usually productive meaning that there is expectoration of mucus. This mucus can vary in color from clear to white, yellow or green. Mucus production may increase during acute flareups of chronic bronchitis which are usually due to infections. Sometimes there may be bloody mucus or gross blood coughed up which is a very serious sign.
Read more on productive cough.
Wheezing is an abnormal breathing sound which is similar to a high pitched whistle. This sound is often associated with asthma but can occur with a number of different respiratory diseases. It may occur in both chronic bronchitis and emphysema to varying degrees. Wheezing may be more noticeable when breathing deeply or rapidly. However, the absence of wheezing does not preclude chronic obstructive pulmonary disease (COPD).
Fatigue is often seen in chronic obstructive pulmonary disease (COPD) and usually worsens as the disease progresses. Oxygenation of the blood is impaired and the lower oxygen levels are one of the main reasons for this fatigue. Furthermore the infections that arises in acute flareups of chronic bronchitis also contributes to symptoms like fatigue. As a result of the fatigue a person may be irritable, disinterested in activities that are usually enjoyable and experience difficulty concentrating
Chest discomfort is more prominent in chronic bronchitis, particularly during acute flareups. The combination of the inflamed bronchi, repeated coughing that causes strain and deep breathing in cases where there is severe shortness of breath, all contribute to the discomfort. It may also be present in emphysema as a result of prolonged labored breathing especially with physical exertion. Due to the increased risk of heart disease, especially in emphysemia, it is important to exclude cardiac conditions as a cause of chest discomfort.
Other Signs and Symptoms
Sometimes the symptoms of chronic bronchitis or emphysema are not as obvious, especially in the early stages. Instead other signs and symptoms need to be noted:
- Pale to blue discoloration of the fingernails.
- Difficulty sleeping, especially without elevating the head.
- Reduced performance at work, with daily tasks and physical activity.
- Swelling of the legs and sometimes the hands (peripheral edema seen in late emphysema)
- Unintentional weight loss particularly in emphysema.
Tests for COPD
There are several diagnostic investigations that are useful in confirming chronic obstructive pulmonary disease when the signs and symptoms are present. It also helps to exclude other diseases like lung cancer which may cause similar symptoms.
- Chest x-ray is helpful for diagnosing pneumonia (lung infection) which can occur with chronic bronchitis.
- Computerized tomography (CT) scan for diagnosing emphysema, especially before the late stages.
- Blood tests to determine the gas exhange (oxygen and carbon dioxide) at the lungs.
- Sputum tests help to identify the cause of the chest infection and specific bacteria responsible for it.
- Lung function test (spirometry) to determine the air capacity of the lung and air flow out of the lung.
Early diagnosis, treatment and management of COPD can help slow the progression of the disease and minimize complications. However, stopping exposure to tobacco smoke, occupational airborne irritants and air pollutants are the main measures needed to stop and if possible, reverse, the condition. Most cases, however, are irreversible by the time that it is diagnosed.